Steroid induced psychosis pathophysiology

In order to determine whether the diagnosis of a psychotic disorder is warranted, the health care professional has to first consider if a medical illness may be the cause of the behavioral changes. If a medical disease is identified or the psychosis is found to be the result of exposure to a medication or drug, the sufferer is assessed as having psychotic disorder due to a medical condition or psychotic disorder due to toxin exposure or withdrawal, respectively. On the other hand, if a medical cause and toxin exposure have been looked for and not found, a psychotic illness such as schizophrenia could be considered. The diagnosis will best be made by a licensed mental-health professional (like a psychiatrist or clinical psychologist), who can evaluate the patient and carefully sort through the diagnostic criteria for a variety of mental illnesses that might look alike at the initial examination, like schizotypal or schizoid personality disorder or a mood disorder with psychotic features like severe depression , or the mania phase of bipolar disorder. Other health care professionals who may treat psychotic disorders may include licensed social workers, psychiatric nurses and nurse practitioners, mental health physician assistants, and sometimes non-psychiatric physicians.

Anders Breivik , known as Norway’s “laughing gunman,” killed 77 people, many of them children, in 2011. Norway officials amassed pages and pages of analysis of the horrific crime, but almost nobody noticed that the smirking Breivik was taking large quantities of mind-altering chemicals, the Daily Mail reported . In this case, the substances are an anabolic steroid called stanozolol, combined with an amphetamine-like drug called ephedrine, plus caffeine. The authorities and most of the media were more interested in his non-existent belief in fundamentalist Christianity, the Mail reported.

Anabolic steroids can cause the development of acne. However, the extent to which it is experienced can be due to a number of varying factors, with the particular steroids and exact dosages used being primary. The skin´s sebaceous glands have a particularly high affinity to Dihydrotestosterone, which is an androgen the body naturally produces from testosterone via the enzyme 5-alpha Reductase. Increased sebaceous gland activity promotes oily skin which can combine with bacteria and dead skin (normal wear and tear) eventually causing pores to become clogged more quickly than the body can cleanse them. This of course, is preventable by using only particular steroids, cleansing the skin regularly, and perhaps using a topical anti-androgen.

Sacks et al. (2005) reported the case of a 72-year-old man, described as professionally successful, intelligent, and cultivated, with polymyalgia rheumatica, who after being treated with prednisone developed a psychosis and dementia , which several behavioral neurology and neuropsychiatry consultants initially diagnosed as early dementia or Alzheimer's disease . [12] Large dosage variations in the patient's medication (including a self-increased dosage from 10 mg/day to as much as 100 mg/day for at least 3 months) produced extreme behavioral changes, from missed appointments to physical altercations, and eventually admission to a psychiatric ward and later to a locked Alzheimer facility. During this time, neuropsychological testing showed a decline in the patient's previously superior IQ as well as deficits in memory, language, fluency, and visuospatial function, which given the patient's age was considered to be compatible with early dementia. When the steroid treatment ended after a year, the patent's confusion and disorganized appearance stopped immediately. Within several weeks, testing showed strong improvement in almost all cognitive functions. His doctors were surprised at the improvement, since the results were inconsistent with a diagnosis of dementia or Alzheimer's. Testing after 14 months showed a large jump in Full Scale IQ from 87 to 124, but mild dysfunction in executive function, memory, attentional control, and verbal/nonverbal memory remained. [12]

Steroid induced psychosis pathophysiology

steroid induced psychosis pathophysiology

Sacks et al. (2005) reported the case of a 72-year-old man, described as professionally successful, intelligent, and cultivated, with polymyalgia rheumatica, who after being treated with prednisone developed a psychosis and dementia , which several behavioral neurology and neuropsychiatry consultants initially diagnosed as early dementia or Alzheimer's disease . [12] Large dosage variations in the patient's medication (including a self-increased dosage from 10 mg/day to as much as 100 mg/day for at least 3 months) produced extreme behavioral changes, from missed appointments to physical altercations, and eventually admission to a psychiatric ward and later to a locked Alzheimer facility. During this time, neuropsychological testing showed a decline in the patient's previously superior IQ as well as deficits in memory, language, fluency, and visuospatial function, which given the patient's age was considered to be compatible with early dementia. When the steroid treatment ended after a year, the patent's confusion and disorganized appearance stopped immediately. Within several weeks, testing showed strong improvement in almost all cognitive functions. His doctors were surprised at the improvement, since the results were inconsistent with a diagnosis of dementia or Alzheimer's. Testing after 14 months showed a large jump in Full Scale IQ from 87 to 124, but mild dysfunction in executive function, memory, attentional control, and verbal/nonverbal memory remained. [12]

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